U.S. Supreme Court Hears Arguments in Landmark Affordable Care Act Case

The U.S. Supreme Court will hear arguments on four issues in the consolidated cases on the Affordable Care Act (ACA) being heard this week from March 26 – 28. The questions are:

  1. Whether Congress had the power to enact the minimum health insurance coverage provision, or individual mandate to have coverage.
  2. Whether that provision is severable from the remainder of the ACA if the minimum coverage provision is found unconstitutional. (In other words, is it possible to remove this provision without making the entire law unworkable?)
  3. Whether the ACA’s requirement that states expand Medicaid eligibility or risk losing federal funds is unduly coercive.
  4. Whether the minimum coverage provision is a tax for the purposes of the Anti-Injunction Act (if it is a tax, then plaintiffs seeking to challenge the provision cannot do so until it goes into effect in 2014).

The Court will hear oral arguments on the Anti-Injunction Act issues on Monday morning (3/26); on the minimum coverage issue on Tuesday morning (3/27); on the severability issue on Wednesday (3/28) morning, and on the Medicaid issue on Wednesday afternoon.

The Arc participated in two amicus curiae (“friend of the court”) briefs in support of the constitutionality of the ACA. The Supreme Court allowed organizations to participate in up to one amicusbrief per each of the four questions that the Court is considering. The Arc participated in briefs in the following cases/issues:

Department of Health and Human Services, et al, v. Florida
Minimum Coverage (Individual Mandate) Issue: The Arc joined several other advocacy and consumer organizations in filing a brief that supports the ACA’s requirement for individuals to purchase health insurance. The brief argues that a law requiring health insurers to cover people with pre-existing conditions cannot function unless it also requires nearly everyone to carry insurance.   This is because, if allowed, people will delay the purchase of insurance until they need expensive care, thereby draining the insurance plan of funds without individuals paying their share. This behavior is known as “adverse selection”.  Seven states have already tried to enact a pre-existing conditions law without a minimum coverage requirement and all seven states saw skyrocketing premiums or worse. Meanwhile, Massachusetts, the one state to enact both pre-existing conditions coverage as well as minimum coverage, saw its premiums go down 40 percent.

Florida, et al, v. Department of Health and Human Services
Expansion of Medicaid Coverage Issue: The Arc joined several other advocacy and consumer organizations in filing a brief that supports the ACA’s expansion of Medicaid coverage. The brief argues that the ACA’s Medicaid expansion is a valid exercise of Congress’ authority to enact legislation under the Constitution’s “Spending Clause,” which empowers Congress to offer money to the states with strings attached. The amicus brief addresses the potential impact of a finding of unconstitutionality on the Medicaid program as well as on other programs in which states similarly receive federal funds in exchange for complying with federal requirements.

Audio Recordings Available: Because of the extraordinary public interest in this case, the Court will provide the audio recordings and transcripts of the oral arguments on an expedited basis through the Court’s website. The audio recordings and transcripts of the March 26-28 morning sessions should be available no later than 2 p.m. on the day of the discussion. The recording and transcript of the March 28 afternoon session should be available no later than 4 p.m. that day. The Court’s website currently provides links to the orders, briefs, and other information about the case.

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